NPI | 1609063833 |
---|---|
Doing Business As | JERICHO ROAD FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | MYRON L GLICK CEO 716-881-6191 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2007-10-02 |
Last Update Date | 2011-12-07 |